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Organization
REFRESH AND RENEW WITH NURSE HENDERSON
Active
Organization
REFRESH AND RENEW WITH NURSE HENDERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRULAN HENDERSON NP (CLINICIAN)
(623) 204-6631
Entity
Organization
Contact information
Practice address
1208 RED BUCKEYE CT, MONCKS CORNER, SC 29461-8600
(623) 204-6631
Mailing address
1208 RED BUCKEYE CT, MONCKS CORNER, SC 29461-8600
(623) 204-6631
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/23/2026
Last updated
02/23/2026
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